To summarize and analyze the clinical characteristics， diagnostic and therapeutic measures for the first child case of severe H5N6 avian influenza pneumonia in China. Methods The clinical data of the first case of severe H5N6 avian influenza infection in China admitted in April 13， 2016 in Department of Emergency Center， Hunan Children’s Hospital were analyzed and summarized.

Results

The case was an 11 years old girl， acute onset， was similar with early symptoms of common respiratory infection including high fever， fatigue， vomiting， but catarrhal symptoms was not obvious. Since fever of unknown origin， obvious weakness， vomiting and other suspected influenza symptoms，clinicians speculated “flu” or “bird flu” possibility considering her history of exposure to her mother died of unknown illness.

The girl was admitted to the Department of Infectious Isolation Ward and received oral oseltamivir treatment. On the 8th day of the course， the condition was aggravated， which showed large areas of dense shadow on chest X-ray film.The girl was diagnosed as acute respiratory distress syndrome（ARDS）， and was transferred to the Intensive Care Unit for isolation and treatment.

Based on the reports of Hunan CDC and National CDC， the girl was confirmed to be a case of avian influenza A H5N6 virus infection case. The treatment started with oseltamivir and then peramivir antivirus treatmnet， nCPAP ventilation， synchronous glucocorticoid treatment， and the gradual weaning of noninvasive ventilator. The girl recovered and was tolerance without oxygen therapy， then discharged from hospital.

Conclusion

It is very important for clinicians to pay more attention to epidemiological history. Timely detection， early diagnosis are crucial to the treatment of avian influenza virus pneumonia and the effective treatment can get better prognosis.

While H5N6 infections are rare, sporadic, and we've no evidence of human-to-human spread, it remains very much a virus worth watching.

For more background on this emerging avian flu threat, you may wish to revisit some of these blogs from last year: